Category: Access to Care

Most of the 275 million Americans with health benefits probably see the logo on the corner of their insurance card and think that’s who has them covered. But for almost 100 million of them—the majority of Americans who get coverage through work—the true insurer is noted somewhere else: on their business card. It’s called self-insurance, and the Obama administration seems interested in curtailing the practice to shore up the Affordable Care Act’s health-insurance exchanges.

According to preliminary data released by the Internal Revenue Service (IRS) in a letter to Congress on July 17, 2015, about 40 percent of households that received subsidies in 2014 are currently at risk of losing their subsidy eligibility because of complications with their 2014 tax returns. To date 1.8 million heads of households have not submitted the appropriate Affordable Care Act (ACA) related tax forms to reconcile the $5.5 billion in subsidies paid on behalf of these households.

The state of Hawaii is likely to extend the operations of the Hawaii Health Connector through October 2016 for $3.3 million, the health insurance exchange’s officials announced Friday at its board of directors meeting.
Hawaii’s state-based insurance marketplace also received confirmation Thursday that the federal government would chip in a $2.8 million grant to support “marketplace assister organizations” — the Connector’s nonprofit partners that assist the community in signing up for health insurance.

A popular middle class tax benefit could become one of the first casualties of the Affordable Care Act’s so-called Cadillac tax, affecting millions of voters.
Flexible spending accounts, which allow people to save their own money tax free for everything from doctor’s co-pays to eyeglasses, may vanish in coming years as companies scramble to avoid the law’s 40 percent levy on pricey health care benefits.

Section 9001 of the Affordable Care Act (ACA), set to take effect in 2018, imposes an “Excise Tax on High Cost Employer-Sponsored Health Coverage”, which has come to be known as the “Cadillac Tax” (not due to a corporate sponsorship from GM, however). This is a 40 percent tax on employer-sponsored health benefits that are defined as “excess benefits,” which is defined as anything in excess of $10,200 (employee only) or $27,500 (family) coverage for 2018, with adjustments for subsequent years. The “excess benefits” include not only benefits provided by the employer, but also the portion of premium paid by the employee, as well as any money the employee chooses to set aside out of salary to pay for health expenses via a Flexible Spending Account (FSA).

New York State has in many ways been a showcase for things that have gone right with Obamacare. The rollout of the state-run health insurance exchange went relatively smoothly and registered patients at a clip well ahead of the national average. Supporters say the exchange’s 2.1 million enrollees are proof positive that the law is increasing consumer choice and fostering a competitive marketplace.

The Nevada Health Co-Op, a consumer-owned and operated health plan created under the Affordable Care Act, is going out of business because of high costs, state officials announced Wednesday.

Consumers insured by the co-op will be covered through Dec. 31, said Janel Davis, spokeswoman for the Silver State Health Insurance Exchange. The Board of Directors for the co-op, which received $65.9 million worth of solvency loans from the federal government, voted to cease operations effective Jan. 1.

Most politicians like to rhapsodize about small businesses – Main Street as opposed to Wall Street – even if their contributions and voting records betray a preference for the latter.

A leading claim made in support of passage of the Affordable Care Act was it would be good for small businesses. In his September 2009 speech to a joint session of Congress, President Obama touted the benefits for small businesses buying through an exchange: “As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance.”

If you bought Obamacare in Georgia or Florida you most likely don’t have a lot of options for choosing doctors or hospitals, according to a new study showing that some enrollees may have less choice than others.